Outbreak of invasive meningococcal disease caused by a meningococcus serogroup B in a nursery school, Wallonia, Belgium, 2018.

Although most invasive meningococcal disease (IMD) cases are sporadic without identified transmission links, outbreaks can occur. We report three cases caused by meningococcus B (MenB) at a Belgian nursery school over 9 months. The first two cases of IMD occurred in spring and summer 2018 in healthy children (aged 3-5 years) attending the same classroom.

The burden of legionnaires' disease in Belgium, 2013 to 2017.

Background: Legionnaires' disease (LD) is a severe bacterial infection causing pneumonia. Surveillance commonly underestimates the true incidence as not all cases are laboratory confirmed and reported to public health authorities. The aim of this study was to present indicators for the impact of LD in Belgium between 2013 and 2017 and to estimate its true burden in the Belgian population in 2017, the most recent year for which the necessary data were available.

High number of hospitalisations and non-classical presentations: lessons learned from a measles outbreak in 2017, Belgium.

We describe and analyse an outbreak of measles that affected Belgium early 2017. In total, 289 cases were reported, mostly (53%) in people 15 years or older. For 133 (46%) vaccination status was unknown and a further 117 (41%) were not vaccinated.

Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges.

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management.

Correction: Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance.

[This corrects the article DOI: 10.1371/journal.pone.

Different measles outbreaks in Belgium, January to June 2016 - a challenge for public health.

During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health.

Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance.

Introduction: Surveillance networks are often not exhaustive nor completely complementary. In such situations, capture-recapture methods can be used for incidence estimation. The choice of estimator and their robustness with respect to the homogeneity and independence assumptions are however not well documented.

Legionnaires' disease: overview of the situation concerning notification in Wallonia (Belgium) in 2012, a retrospective descriptive study based on a capture-recapture method.

Background: Legionnaires' disease is a severe form of pneumonia, and although public health medical inspectors must be notified, it is often under-reported. The objectives of this study were to determine the completeness rate of notification of Legionnaires' disease and to estimate the incidence of this disease in Wallonia, the southern part of Belgium, in 2012.

Method: This retrospective, transversal descriptive study was based on a capture-recapture method using two sources.

[Reorganization of the provincial health system in the Democratic Republic of the Congo].

Introduction: In the framework of implementation of health system reform in the Democratic Republic of the Congo (DRC), and in a context of decentralization dictated by the National Constitution, this study presents the process and results obtained in terms of the provincial level of health care organization in DRC.

Methods: A two-year multidisciplinary interventional research protocol was elaborated with two phases and 9 steps including organizational analysis, team building, and organizational learning. It resulted in transformational actions and improved knowledge, allowing the development of an innovative organizational model of the intermediate level of the health care system in the Democratic Republic of the Congo.

[Stakeholder representations of the role of the intermediate level of the DRC health system].

Introduction: Intermediate health care structures in the DRC were designed during the setting-up of primary health care in a perspective of health district support. This study was designed to describe stakeholder representations of the intermediate level of the DRC health system during the first 30 years of the primary health care system.

Methods: This case study was based on inductive analysis of data from 27 key informant interviews.

Toxigenic Corynebacterium ulcerans in human and non-toxigenic Corynebacterium diphtheriae in cat.

Corynebacterium diphtheriae and Corynebacterium ulcerans are rarely isolated from clinical samples in Belgium. A case of toxigenic C. ulcerans in a woman is described, which confirms that this pathogen is still present.

[Supporting the intermediate level of health care in urban health areas in Kinshasa (1995-2005), DR Congo].

As a result of the decentralization of health systems, some countries have introduced intermediate (provincial) levels in their public health system. This paper presents the results of a case study conducted in Kinshasa on health system decentralization. The study identified a shift from a focus on regulation compliance assessment to an emphasis on health system coordination and health district support.

Community volunteers can improve breastfeeding among children under six months of age in the Democratic Republic of Congo crisis.

Background: Malnutrition is a major public health problem in developing countries and exclusive breastfeeding is an efficient strategy that can be used to prevent malnutrition and reduce child mortality. The objective of this study is to evaluate the effectiveness of community volunteers in promoting exclusive breastfeeding from birth in an area of endemic malnutrition.

Methods: This evaluation analyzed the impact of the community-based nutrition project in Katana health district of the Democratic Republic of Congo from 2004 to 2006.

Understanding couples' attitudes on prenatal HIV testing in the Democratic Republic of Congo.

Background: The prevalence of HIV-serodiscordant couples is increasing. In these couples, one member is infected with HIV and the other one is not, so HIV testing for both members of the couple remains one of the significant challenges in the prevention of sexual transmission of HIV within the couple. The aim of this study was to analyze couples' attitudes toward HIV testing after prenatal HIV testing offered to pregnant women and analyze the males' behavior with regard to their own HIV testing.

[Impact of mid-level management and support on the performance of a district health system in the Democratic Republic of the Congo].

Introduction: The aim of this study was to assess the contribution of mid-level management and support practices to the overall performance of a district healthcare system.

Methods: This case study was carried out in the North Kivu Province of the Democratic Republic of the Congo. It was based on analysis of (i) preventive and curative healthcare services and (ii) management and support practices provided from 2000 to 2008.

[Factors associated with malnutrition in children aged under five years in Lubumbashi (DRC)].

Nutritional status of children is a global indicator of children's well-being and, indirectly, of the community's well-being. The first objective of this work is to assess the nutritional status of children under five years-old living in a suburb of the city of Lubumbashi, DR Congo, at the end of the 1998-2003 armed conflict. The second objective aims to identify some predictors of malnutrition.

[HIV-1 test acceptance within the prevention of mother-to-child HIV-1 transmission program in Democratic Republic of Congo].

Background: HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care.

Methods: Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study.

Microbiologic and clinical features of Salmonella species isolated from bacteremic children in eastern Democratic Republic of Congo.

Background: The morbidity of Salmonella bloodstream infections is unacceptably high in Africa. In 2000, the WHO Global Salmonella-Surveillance (GSS) program was founded to reduce the health burden of foodborne diseases. The incorporation, in 2002, of the Democratic Republic of Congo (DRC) in this program allowed the improvement of laboratory capacities.

[Intra-hospital mortality of children in central Africa: looking at the impact of a training programme and increased supervision].

The study's aim was to evaluate the impact of an in-service training course and supervision of physicians and nurses in terms of quality of care on intra-hospital mortality. The study included 2 cohorts of children. Cohort 1 included 414 children from 0 to 15-years-old who were followed in the paediatric wards of the provincial hospital of Goma (HPG) between April 1, 2003 and March 31, 2004.

[The effectiveness of community volunteers in counting populations and assessing their nutritional vulnerability during armed conflict: district health in D.R. Congo, Central Africa].

The study assessed the ability of community volunteers, working with district health officials, to conduct a local census to count the population in their villages and assess their nutritional vulnerability. The study involved organizing community volunteers in village nutrition committee and assigning them to count the village population in a Kivu rural health district (D.R.

Nutritional monitoring of preschool-age children by community volunteers during armed conflict in the Democratic Republic of the Congo.

Background: The coverage of preschool preventive medical visits in developing countries is still low. Consequently, very few children benefit from continuous monitoring during the first 5 years of life.

Objective: To assess community volunteers' effectiveness in monitoring the growth of preschool-age children in a context of endemic malnutrition and armed conflict.

[Safety aspects of the practical application of a gI-negative subunit vaccine against Aujeszky's disease in swine].

On two farms in an area in which Aujeszky's disease is endemic, 192 pregnant sows were vaccinated with a gI-negative sub-unit vaccine against Aujeszky's disease. The rectal temperatures of the sows were recorded once daily for seven consecutive days, starting on the day of vaccination, and the vaccinated animals were observed for local and systemic reactions. The temperatures recorded did not exceed 39.